Anton-Babinski Syndrome-Visual Agnosia with Confabulation

Anton-Babinski syndrome is visual anosognosia (denial of loss of vision) associated with confabulation (defined as the emergence of memories of events and experiences that never took place) in the setting of obvious visual loss and cortical blindness. A 52-year-old Yemeni man was admitted with headache and vomiting for 3 days. His wife informed that he had a history suggesting visual anosognosia (frequent collisions with objects on his way and he tried to walk through closed doors when moving from one room to another) and confabulation (used to say that he could see objects around him which do not exist in reality). He had hypertension and ischemic heart disease in the past but was not compliant with his medications. He was a smoker and had no other habits. On examination, he was fully conscious and oriented, looked depressed, and his blood pressure was high (180/100mm Hg). He had only light perception in both eyes in all the visual fields, pupils were 2mm bilateral and were equally reacting to light, ocular movements were preserved and the fundoscopic examination showed grade 2 hypertensive retinopathy (arterial narrowing with focal irregularities). The rest of the neurological examination was unremarkable. Biochemical parameters showed mild renal impairment (serum creatinine 2.9mg/dL). Computed tomography of the head showed hypodense areas in the right high parietal and left occipital regions. Magnetic resonance imaging of the brain showed a large acute infarct in the right temporo–parieto–occipital region and a subacute infarct in the left occipital region [Figure 1]. He was treated with antiplatelets, atorvastatin and antihypertensive medications.Figure 1: Magnetic resonance imaging of the brain showing a large acute infarct in the right temporo–parieto–occipital region (a), and a subacute infarct in the left occipital region (b).Anton’s syndrome is the denial of loss of vision (visual anosognosia) associated with confabulation in the setting of obvious visual loss and cortical blindness. Patients with damage to the occipital lobes bilaterally may have damage to their visual association cortex, which may account for their lack of awareness. Damaged visual areas are effectively disconnected from functioning areas, such as speech–language areas resulting in confabulation. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.